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Diagnosis
Clinical examination had poor sensitivity for detecting non-cephalic presentation in late pregnancy

https://doi.org/10.1136/ebm.12.2.54

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    Nassar N, Roberts CL, Cameron CA, et al. Diagnostic accuracy of clinical examination for detection of non-cephalic presentation in late pregnancy: cross sectional analytic study. BMJ 2006;333:578–80.
    OpenUrlAbstract/FREE Full Text

    
 
 Q Is clinical examination as accurate as ultrasonography for identifying fetuses in non-cephalic presentation in late pregnancy?

    Clinical impact ratings GP/FP/Obstetrics ★★★★★★☆ Obstetrics ★★★★☆☆☆

    METHODS

    Embedded ImageDesign:

    blinded comparison of clinical examination and ultrasonography.

    Embedded ImageSetting:

    antenatal clinic in tertiary obstetric hospital in Sydney, New South Wales, Australia.

    Embedded ImagePatients:

    1633 women (mean age 31 y) with a singleton pregnancy at 35–37 weeks’ gestation.

    Embedded ImageDescription of test:

    clinical examination to assess fetal presentation was performed as part of routine antenatal care by residents or registrars (55% of examinations), midwives (28%), or obstetricians (17%).

    Embedded ImageDiagnostic standard:

    ultrasound examination of the fetus using a hand held machine.

    Embedded ImageOutcomes:

    sensitivity, specificity, and likelihood ratios.

    MAIN RESULTS

    In 130 women (8.0%), the fetus was in non-cephalic presentation: 6.3% in breech presentation and 1.7% with transverse or oblique lie. The diagnostic characteristics of clinical examination, compared with ultrasonographic …

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    Footnotes

    • For correspondence: Dr N Nassar, Telethon Institute for Child Heath Research, West Perth, Western Australia, Australia. natashan{at}ichr.uwa.edu.au

    • Source of funding: Australian National Health and Medical Research Council.